Dealing with health inequalities is not a new challenge. We have more than 30 years of history in this field. Yet, inequalities remain a constant problem despite improvements in data, knowledge, policies, and interventions. Health inequity continues to be both the catalyst and product of unequal economic, social, and environmental conditions, which are inherently unfair, unjust, and avoidable.

Knowing that current thinking about tackling health inequalities needs to look for new solutions, this conference (see endnotes for more information) showed how the HealthEquity-2020 project has looked to take advantage of integrated regional policies to help improve our population’s health. Professionals, policy makers and researchers from across the EU at regional, national and European levels came together to discuss how this could be done.

“What do we need to do to change the situation on the ground and close the inequalities gap?” – was the question put by Anthony Buchanan, Vice-Chair of the Commission of Natural Resources of the CoR.

He emphasised that “First and foremost we need the courage and vision to bring about that change. We need to safeguard the values of universality, access to good quality care, equity and solidarity, and make sure they are not overshadowed by concerns depicted by the economic situation”.

He concluded, “We need evidence to make the right policy choices. And last but not least we need to stop working in silos, and move towards integrated cross-sectoral planning and care delivery. It is not just about the debate between health and social affairs, it is about making sure that health outcomes are considered from all angles and at present, in all policies; only then can health inequalities truly and seriously addressed”.

KEY MESSAGES FROM HEALTHEQUITY-2020

In tackling health inequalities a number of key considerations deserve reflection from a regional point of view:

Focus on regions - Our project was sensitive to the reality that all of the 10 participating regions had different starting points in addressing common problems. We shared how far we have got with this mutual work by presenting and discussing valid examples of realistic, viable, and adopted action plans to deal with health inequalities at regional and national level.

Using evidence - Adopting an evidence-based approach is key to develop regional action plans that can deal with socioeconomic health inequalities effectively. Collecting and using evidence should be part of our working culture as it can help reach informed decisions. The developed HE2020 Toolkit is to assist this evidence-based approach.

Intersectoral work - Tackling health inequalities requires intersectoral work. Successful collaboration between relevant organisations has to build on the foundations of necessity and opportunity. To be able to set and achieve local goals we need to strengthen existing working relationships and build new ones in order to maximise how available resources can be used to best effect.

Benefits of working together – What is critical are pooling local/regional assets and resources to work together.Collaboration between organisations from public, private and civic sectors is needed to tackle the multifaceted problem that is inequalities. To be successful and overcome difficulties together, the vision, commitment and networks of potential agencies, partners in the collaborative work should be understood by all parties involved in order to be able to address issues of common concerns.

Regional Action Groups - Regional (or Local) Action Groups are good means to bring together organisations from different sectors where cooperation needs to be driven from senior level. Key stakeholders and interest groups have to be engaged to recognise different and overlapping areas of interest and perceived needs for which an action group is an ideal platform for working together. Strategic planning is likely to be more successful when it is financed and implemented jointly by all relevant parties.

Integrated planning for higher-level decision-making - To reduce health inequalities evidence-based action plans formed and implemented through cross-sectoral cooperation are necessary. One guarantee of successful implementation is achieved by incorporating specific, health inequality focused action plans into wider regional and/or national development plans in order to promote and ensure synergies in decision making and funding. Finding out ways for how to get those priorities integrated into a regional or even a national planning cycle has been one of the biggest challenges.

ENDNOTES

1. HEALTH EQUITY 2020 SOLUTIONS

The conference was organised as part of a Health Programme project which was working with EU regions to bring available knowledge, data, and good practice into focus locally. The aim was to assist EU regions to develop evidence-based action plans to tackle health inequalities. During its 3,5 years the project generated resources to help this work, collected regional case studies, and practical examples of how to realise the necessary actions and overcome obstacles and difficulties. The project developed tools and a comprehensive action learning programme to support regions in (i) identifying the gaps between the current regional situations and the desired outcomes with respect to socioeconomic health inequalities and needs, and (ii) acting upon that. The project provided specific learning opportunities for the regions to expand their knowledge and skills in order to develop and adopt local or regional action plans that address existing needs and priorities by building local capacities.

2. THE AIM OF THIS CONFERENCE

The aim of the conference was to present these resources, case studies, and practical examples, and to review the key findings in the context of the emerging EU policy and planning. The conference focussed on challenges that EU regions face in seeking to tackle health inequalities through evidence-based action planning. In particular, partner regions identified immediate benefits they had from the project and that what obstacles remain in this process. Participants discussed how to collect evidence for our work, how to deal with the data, and base our work on that, how to maximise impact of action planning at regional level, how to engage decision makers in the planning process, and how to link this work to wider regional and national development activities. Financial resources to address regional priorities were also reviewed with special regard to Structural and Investments Funds and other alternative sources.